ABOUT MYSELF

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Dr Gaurav Singal is a vibrant and dynamic personality who likes challenges. Impossible is the word that eggs him on to take on the challenging vascular surgery cases. He did his graduation and post graduation from Dayanand Medical College Ludhiana in 1999. He then left for the US where he developed interest in vascular surgery as he was associated with a vascular surgery team of Indian origin there in New York. He was so fascinated with this specialty that he came back home and got trained in this super specialty from the reputed NIZAMS INSTITUTE OF MEDICAL SCIENCES HYDERABAD in 2003.This institute is a deemed university and has the maximum vascular surgical patient workload in the country. He then worked for good 5 years till April 2009 in Krishna institute of medical sciences as a consultant vascular surgeon and was the only vascular surgeon there dedicated exclusively to peripheral vascular surgery. He not only established the vascular department there but gave a new dimension to vascular surgery as a whole. He had the privilege to work under two reputed vascular surgery centers in Germany Europe in 2006.He was sponsored by the VASCULAR SOCIETY OF INDIA for further training to hone his skills. He was in KREIS KRANKENHAUS (KKH) RENDSBURG GERMANY and then had the chance to meet and assist Dr W.SANDMANN in HEINERICH HEINE UNIVERSITAT, DUSSELDORF GERMANY (HHE) in 2006. Dr Sandmann is an authority in vascular surgery in Europe and his centre is a leading centre in Germany and Europe for difficult vascular surgeries.
Dr Gaurav has many firsts to his name like creating a unique dialysis access in an amputee which is first of its kind case in the world. He has to his credit operating on a 17 years old girl with multiple aneurysms of the aorta due to Takayasu Arteritis. Subtotal Aortic replacement was done in one sitting making it first of its kind case in the world. He has the largest series of composite vascular surgical procedures in contemporary times done in a calendar year wherein bypass of the heart and aortic bypass were done simultaneously in the same sitting. He also has to his credit doing surgeries for acute DVT .No other centre in India excels In doing venous Thrombectomies on a regular basis with good results.
His field of interest lies in carotid surgeries, aortic surgeries,vascular trauma, renovascular hypertension, mesenteric ischaemias, distal bypasses till the dorsalis pedis arteries to save the leg from amputations, venous thrombectomies, venous/dialysis access in difficult cases with or without synthetic graft with special interest in takayasu arteritis and redo vascular surgery cases. Varicose veins is another vascular disease he deals in.
There are very few qualified and trained vascular surgeons in India(approximately Thirty). Situation is no better in North India .
I would be happy to address problems concerning vascular surgery .

Lieomyosarcoma of the IVC(Inferior Vena Cava)

Lieomyosarcoma of the IVC(Inferior Vena Cava)

Tumors of the blood vessels are very rare so to speak.Still rarer is their diagnosis and therefore treatment options and guidelines regarding their management are still evolving.We report to you a similar case that was operated in our setup in chandigarh until recently.
This man aged 66 years reported to our hospital with large mass abdomen and was not able to eat or drink as he used to vomit out whatever he took orally.Added to it was a recent onset of swelling in both his lower limbs.He went to different hospitals of repute including two regional reputed medical schools which denied him surgery saying he would die on table.This guy almost resigned to his fate till someone suggested him to see us in our centre .
Seeing his CT scan we realized he either has a retroperitoneal mass impinging his Inferior Vena Cava (main blood vessel of the body that carries blood back to the heart) or else it’s a tumour arising from the Ivc itself.

We took up the challenge of operating him as we were inclined to give him a new lease of life.Surgery lasted for almost like six hours and we were able to excise the whole mass .Ivc was removed enbloc with the tumour and almost 20 cms of Ivc was replaced with 14 mm PTFE graft.To be honest with you operating on the Ivc is no easy job as the vessel usually is thin walled and becomes more friable in the setting of an underlying pathology as was in this case.Anyways we don’t accept failures and that is what made us come out victorious.
During the writing of this article ,the concerned patient is recuperating in the hospital and would be discharged in a couple of days from now on.

Not many cases have been operated in India going by the date available on internet.

The take home message is not to be disheartened in life for there always is light at the end of the tunnel.

MYCOTIC ANEURYSM OF THE ANTERIOR TIBIAL ARTERY

MYCOTIC ANEURYSM OF THE ANTERIOR TIBIAL ARTERY

Mycotic aneurysms of the lower limb vessels are rare.Still rarer is to find mycotic aneurysms of the small sized tibial vessels of the legs.Few cases of mycotic aneurysm involving posterior tibial artery has been reported .We report a case of mycotic aneurysm of the anterior tibial artery done in our institute until recently.To the best of our knowledge this is the first of its kind case reported in vascular surgery literature wherein the origin of anterior tibial artery was involved .

A 42 years old man came to the hospital complaining of severe pain in his left leg of short duration.The pain was so severe that he was not able to walk even few steps.He had no significant medical history and was not on any kind of medications.On examination it was found that his left leg was swollen and left foot was cold.Left dorsalis pedis and posterior tibial artery pusations were not felt.He was febrile and subsequent examination revealed he had mitral valve disease with fresh vegetations on its leaflets.So a diagnosis of infective endocarditis was clinically made which was subsequently confirmed my 2D Echo and CT angio of the patient.
Patient was explained in detail as to what was going on and was taken up for emergency surgery of his left leg as blood flow was severely compromised which could have endangered the viability of his leg otherwise.Under strong antibiotic cover the surgery was performed.Left ATA mycotic aneurysm was excised in totality. Blood circulation was restored in the other vessel of the leg i.e posterior tibial artery .Reconstruction was not done for the anterior tibial artery for fear of infection and subsequent vascular blowout because of underlying infective pathology.
Patient was discharged on the 5th post.operative day and is advised to be in regular follow up of my own self and the cardiologist.